Do not take a double dose to make up for a missed one. 3 to 6 years: 87 mg every 30 minutes to 1 hour as needed. Medication should never be administered without first consulting your veterinarian. A 30-mL dose of the liquid formulation contains 258 mg salicylate and 303 mg bismuth. There are no serious complications caused by giving Pepto-Bismol to dogs, although there is not complete agreement that it is helpful either. Found inside – Page 194Bismuth subsalicylate is an effective and safe agent for the prevention and treatment of travelers' diarrhea.22 Protection ranges from 40% to 65%, according to the amount and frequency of the dose. For best protection it should be taken ... Please enable it to take advantage of the complete set of features! eCollection 2010 Jun 10. Bismuth subsalicylate can decrease the absorption of oral tetracycline antibiotics if used at the same time. WARNING – PLEASE NOTE THAT THE NEW FORMULATIONS OF KAOPECTATE MAY ALSO HAVE SALICYLATES. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The dosage of chewing tablets is 8.5 mg/pound or 85mg/10 pounds. Bismuth subsalicylate may cause other side effects. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with bismuth subsalicylate. Take bismuth subsalicylate exactly as directed. Do not take more than 8 doses in one day (24 hours). Fernandes HVJ, Houle SKD, Johal A, Riddle MS. Can Pharm J (Ott). If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. 6 to 9 years: 175 mg every 30 minutes to 1 hour as needed. enable_page_level_ads: true There are many brands and forms of bismuth subsalicylate available. Supplements containing bismuth usually contain bismuth as a salt. Top of the page bismuth subsalicylate Pronunciation: BIZ muth sub sa LISS i late Brand: Bismarex, Bismatrol, Bismatrol Maximum Strength, Kaopectate, Kola-Pectin DS, Peptic Relief, Pepto-Bismol, Percy Medicine, Pink Bismuth, Soothe Caplets Peptic Reliefslide 1 of 3, Peptic Relief, 262 mg, round, pink, imprinted with GDC 122 slide 1 of 3 Pink Bismuthslide 2 of 3, Pink This is a harmless side effect. This is a harmless side effect. Systematic Review and Meta-Analyses Assessment of the Clinical Efficacy of Bismuth Subsalicylate for Prevention and Treatment of Infectious Diarrhea. Bismuth subsalicylate exerts a local effect on the gastric mucosa, coating it and protecting it from the corrosive effects of acid and pepsin. Bismuth subsalicylate is commonly used in over-the-counter medicines to relieve heartburn, indigestion, upset stomach, nausea, diarrhea, and other gastrointestinal ailments. With prolonged dosage, actual salicylism has occurred. Dig Dis Sci. you notice any change in your urine sugar test results. Found inside – Page 601Bismuth subsalicylate produced antiemetic effects in ipecac-treated dogs with 44 mg/kg producing an effective dose in 50% of the dogs, whereas 175 mg/kg was an effective dose in 90% of dogs.12 The currently recommended dose of bismuth ... Those allergic to aspirin may suffer as will children susceptible to Reye's syndrome. Bismuth Subsalicylate . This site needs JavaScript to work properly. Bismuth subsalicylate comes as a liquid, tablet, or chewable tablet to be taken by mouth, with or without food. Adults. For oral use only. Do not take more or less of it or take it more often than recommended by the manufacturer or your doctor. Do not take more of this medication than recommended for your age. Such drugs include tetracycline, steroids, non-steroidal anti-inflammatory drugs and aspirin. Shake the liquid well before each use to mix the medication evenly. Can Commun Dis Rep. 2010 Jun 10;36(ACS-3):1-31. doi: 10.14745/ccdr.v36i00a03. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Found inside – Page 503In clinical practice , therefore , the treatment regimen with the simplest dosing requirement and fewest side effects is to be preferred , assuming similar ... A 30 mL dose of bismuth subsalicylate contains 230 mg of salicylate . Bismuth subsalicylate is also used in conjunction with other medications to treat H. pylori.. Bismuth subsalicylate is available under the following different brand names: Kaopectate, Pepto Bismol, Maalox Total . Bismuth subsalicylate (Pepto Bismol, Kaopectate, Bismatrol Maximum Strength, and many other brands) is an over-the-counter (OTC) drug used to prevent traveler's diarrhea, and to treat diarrhea, upset stomach, nausea, indigestion, heartburn, and H. pylori infection. Bismuth overdose may present as acute encephalopathy with confusion, myoclonus, tremor, dysarthria and gait disturbances. Using other salicylate-containing products while taking bismuth subsalicylate may lead to overdose. ask your doctor before taking this medication if you have ever had an ulcer, bleeding problem, stools that are bloody or blackened, or kidney disease. The total daily dose should be divided into two to four doses. Prevention and treatment information (HHS). It is also used to treat diarrhea and help prevent travelers' diarrhea. The product's dosage form is tablet, chewable and is administered via oral form. It exerts bactericidal action against H.pylori which is accepted to be the causative factor in chronic gastritis and duodenal ulcer. use until diarrhea stops but not more than 2 days. Found inside – Page 5Bismuth subsalicylate in oil : average dose is 0.2 gm . of bismuth subsalicylate , the amount contained in 1-1 / 2 cc . of the oily susp ion . .5 . Application of Treatment Schedules Stage of Syphilis Recommended Treatment Schedule ... Salicylates can cause serious bleeding problems when used alone in patients with ulcers.Check the ingredients on the label even if you have used the product . Bismuth subsalicylate is an antacid and anti-diarrhea medication that is used to treat diarrhea, heartburn, nausea, indigestion and upset stomach in adults and children 12 years of age and older. There are no controlled data in human pregnancy. Bismuth subsalicylate treatment was better than ranitidine at both four and at eight weeks (p less than 0.05). Cfinicaf Pharmacology and Therapeurics, 29,788-792. doi: 10.1093/clinids/8.supplement_2.s151. If you will be giving bismuth subsalicylate to a child or teenager, tell the child’s doctor if the child has any of the following symptoms before he or she receives the medication: vomiting, listlessness, drowsiness, confusion, aggression, seizures, yellowing of the skin or eyes, weakness, or flu-like symptoms. There are many brands and forms of bismuth subsalicylate available. Also ask your doctor before taking bismuth subsalicylate if you have a fever or mucus in your stool. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Be certain to complete the prescription unless specifically directed by your veterinarian. Bismuth subsalicylate is available in the following dosage forms: Bismuth subsalicylate is to be taken by mouth, with or without food. ask your doctor about taking this medication if you are pregnant or are breast-feeding. How to Take Pepto Bismol. This is a harmless side effect. Call your doctor for medical advice about side effects. Found inside – Page 120Bismuth subsalicylate in oil dosage : The standard dose is 0.2 gm . of bismuth subsalicylate intramuscularly ( not 0.2 gm . of elemental bismuth metal ) . unsid moule TUR osalemler ans com ( 3 ) Technical Suggestions . Pregnancy categories A, B, C, D and X are being phased out. Pediatric suspensions of bismuth subsalicylate is available containing 87 mg per 5 ml (one teaspoon). Bismuth subsalicylate, sold as generic and under the brand name Pepto-Bismol and BisBacter, is an antacid elixir medication used to treat temporary discomforts of the stomach and gastrointestinal tract, such as nausea, heartburn, indigestion, upset stomach, and diarrhea.It is also commonly known as pink bismuth, but Pepto-Bismol has become a genericized trademark for the substance. 9 to 12 years: 262 mg every 30 minutes to 1 hour as needed. Found inside – Page 10Bismuth subsalicylate - intramuscu . larly once weekly - 6 doses . ... Bismuth subsalicylate in oil dosage : The standard dose is 0.2 gram of bismuth subsalicylate intramuscularly ( not 0.2 gram of elemental bismuth metal ) . 1. Overdose. Found inside – Page 75Small and Large Animal Mark G. Papich, DVM, MS, DACVCP. Bismuth Subsalicylate 75 Large Animal Dosage • No dose has been reported for large animals. B. Regulatory Information Do not administer to animals intended for food. Bismuth. This single-dose medicine contains milligram quantities of bismuth(III) in complex with salicylate. Tablets contain 262 mg bismuth subsalicylate per tablet. Label: KROGER STOMACH RELIEF- bismuth subsalicylate tablet, chewable Label RSS; Share Found inside – Page 156TABLE 10.8 ANTIDIARRHEAL AGENTS First-line therapy Adsorbents such as bismuth subsalicylate (Pepto-Bismol) and ... to 1 hour Bismuth subsalicylate (Kaopectate) PRN; maximum daily dose: eight regular-strength doses 2 tablespoonfuls every ... If it is close to the time for your next dose, skip the missed dose and go back to your normal time. Johnson PC, Ericsson CD, DuPont HL, Morgan DR, Bitsura JA, Wood LV. This drug is registered for use in humans and animals. carbonic anhydrase inhibitor levels, risk of CNS toxicity, metabolic acidosis, other adverse effects; may incr. Human formulations: Pepto-Bismol® (Procter & Gamble), Bismatrol® (Major), Kaopectate® (Pharmacia) and other generic formulations are available. dark colored stools. It is the only OTC bismuth compound available in the United States and is estimated to be used by most American households. Drug Facts. What is the dosage for bismuth subsalicylate-oral? Du Pont, H.L. -Bismuth subsalicylate may be useful in the prevention of . Bismuth Subsalicylate is a bismuth salt of salicylic acid. Available in gallons. Over-the-counter treatment of nonspecific diarrhea in adults and adolescents (= 12 years): Chewable tablets, caplets, liquids containing 262 mg/15 ml: 524 mg by mouth every 30-60 minutes as needed. Bismuth subsalicylate is used to treat diarrhea, heartburn, and upset stomach in adults and children over 12 years of age. For the treatment of indigestion, relief of gas, heartburn, upset stomach, and nausea. Diarrhea, gas, indigestion, heartburn, nausea: 524mg (2 tabs regular strength) PO q30m PRN, max 8 doses regular strength or 4 doses extra-strength daily; H. pylori: 524mg (2 regular-strength tablets or 1 extra-strength tablet) + 250 mg metronidazole + 500 mg . 1986 May-Jun;8 Suppl 2:S151-9. Epub 2020 Aug 8. Do not take more of this medication than recommended for your age. Bismuth subsalicylate is the main ingredient in Pepto-Bismol. Protection rates were 65% for high-dose and 40% for low-dose bismuth subsalicylate. Do not increase your dose or take this drug more often than directed. The NDC Code 69618-029-03 is assigned to a package of 30 tablet, chewable in 1 bottle, plastic of Bismuth Subsalicylate 262 Mg, a human over the counter drug labeled by Reliable 1 Laboratories Llc. Salicylates can cause a serious and sometimes fatal condition called Reye’s syndrome in children. For oral use only. After a single oral dose of 525 mg bismuth subsalicylate (2 chewable tablets), the mean peak plasma salicylic acid concentration was 13.1 ± 3.4 µg/mL under fasted condition. This is not a complete list of side effects and others may occur. (adsbygoogle = window.adsbygoogle || []).push({}); (adsbygoogle = window.adsbygoogle || []).push({ Summary. vs. 250 mg 5 times daily, and 250 mg of metronidazole q.i.d. Text revised 11/2015 PL 00129/0143 Read the instructions carefully before taking the product - if you have any questions, ask your doctor or . In these cases, your doctor may want to change the dose, or other precautions may be necessary. The dosage is based on your age, medical condition, and response to treatment. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The dosage of two tablets of bismuth subsalicylate four times daily (2.1 g/d) appears to be a safe and effective means of reducing the occurrence of travelers' diarrhea among persons at risk for periods up to three weeks. The recommended dosages are: bismuth subsalicylate, 525 mg (two 262.4 mg-chewable tablets), metronidazole, 250 mg (one 250-mg tablet), and tetracycline hydrochloride, 500 mg (one 500-mg capsule) taken four times daily for 14 days plus an H2 antagonist approved for the treatment of acute duodenal ulcer. doi: 10.5041/RMMJ.10422. Children—Should not be used in children younger than 12 years of age. Bismuth subsalicylate reacts with HCl in the intragastric environment (pH < 3.5) to form Helidac may also be used for purposes not listed in this medication guide. Bookshelf Bismuth Subsalicylate 525 mg/30 mL dsspl09100A Bismuth Subsalicylate 525 mg/30 mL Bismuth Subsalicylate is used to treat occasional upset stomach, heartburn, and nausea. Tell any doctor who treats you that you are using bismuth subsalicylate. It belongs to a drug class called salicylates. You may report side effects to FDA at 1-800-FDA-1088. Common side effects include: constipation; or. Please note that do not give Ultra Pepto Bismol without calculating the safe dose because the Ultra Pepto Bismol is concentrated with double bismuth subsalicylate. This book focuses on the impact of pregnancy on drug disposition and also includes coverage of treatments for diseases of specific body systems, as well as essential content on dosing and efficacy. You should not take more than 16 tablets in twenty-four hours. Bismuth subsalicylate is available without a prescription. THE ESSENTIAL WORK IN TRAVEL MEDICINE -- NOW COMPLETELY UPDATED FOR 2018 As unprecedented numbers of travelers cross international borders each day, the need for up-to-date, practical information about the health challenges posed by travel ... Myoclonic encephalopathy has occurred in patients who have ingested bismuth for several months to years, but the incidence is very rare. <= 10 years: 262 mg four times a day for six weeks, > 10 years: 524 mg four times a day for six weeks, muscle spasms (especially of face, neck, and back), nausea or vomiting (severe or continuing), uncontrollable flapping movements of the hands (especially in elderly patients) or other uncontrolled body movements, Rare (less than 0.1%): Myoclonic encephalopathy, Frequency not reported: Weakness, fatigue, depression, anxiety, irritability, insomnia, unsteady gait, motor incoordination, loss of memory, jerky movements, mental confusion, disorientation, difficulty in walking and speaking, tremor, myoclonic jerks, incontinence. MeSH ©Copyright 1999 - 2021. Follow the directions on the package carefully, and ask your doctor or pharmacist to explain any part you do not understand. Gastroenterology. Bismuth(III) complexes are used in medicine. tell your doctor or pharmacist if you are allergic to salicylate pain relievers such as aspirin, choline magnesium trisalicylate, choline salicylate (Arthropan), diflunisal (Dolobid), magnesium salicylate (Doan’s, others), and salsalate (Argesic, Disalcid, Salgesic); or any other medication. The elderly may be particularly vulnerable to the development of salicylism. Bismuth subsalicylate works by decreasing the flow of fluids and electrolytes into the bowel, reduces inflammation within the intestine, and may kill the organisms that can cause diarrhea. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. Whether you’re concerned about the drugs a patient is already taking or the drugs you prescribe for treatment, this book helps you reduce risk and provide effective dental care. Double-blind comparison of bismuth subsalicylate and placebo in the prevention and treatment of enterotoxigenic Escherichia coli-induced diarrhea in volunteers. adults and children 12 years and over. It is sometimes used by vets to treat dogs with diarrhea or Helicobacter infections, but should be kept well away from any cats in your home as they tend to be particularly sensitive to the drug. Rev Infect Dis. 30 mL (1 dose) every 1/2 or 60 mL (2 doses) every hour as needed for diarrhea/traveler's diarrhea. This amounts to approximately 2 teaspoons (10 ml total) per 10-pounds per day, ideally split between two to four doses. Diarrhea caused by enterotoxigenic Escherichia coli was found in one student receiving the high-dose regimen, in no students receiving the low-dose regimen, and in seven placebo-treated subjects. After stopping bismuth therapy bacterial recrudescence frequently occurred. Found inside – Page 87BISMUTH SUBSALICYLATE INJECTION , U. S. P.Dose of bismuth subsalicylate : intramuscular , 0.1 gm . ( 11/2 gr . ) . BISMUTH POTASSIUM TARTRATE , U. S. P. ( Bismuthi Potassii Tartras — potassium bismuth tartrate ) . Overdosing with bismuth subsalicylate is very difficult to achieve, and therefore uncommon, especially with adult horses. Salicylism has been reported in patients who chronically ingest bismuth subsalicylate. Consult WARNINGS section for dosing related precautions. This is not a complete list of side effects and others may occur. Bismuth Subsalicylate This information from Lexicomp explains what you need to know about this medication, including what it's used for, how to take it, its side effects, and when to . This medication is usually taken as needed. Oral suspensions of bismuth subsalicylate are available over-the-counter containing 262 milligrams (mg) per 15 ml (one tablespoon), or 525 mg per tablespoon in the "extra strength" form. ;(OTC) Labeled for use in cattle, horses, calves, folas, dogs and cats. Pet owners should be aware that the bismuth compound causes a discoloration, usually a darkening, of the pet’s bowel movements. Found inside – Page 536Know that bismuth subsalicylate and bismuth subcitrate are used in these combinations for their antimicrobial effects ... bismuth subcitrate, metronidazole, and tetracycline triple therapy to swallow the three capsules of each dose with ... Not to exceed 8 doses in 24 hours. It is a highly insoluble salt of trivalent bismuth and salicylic acid. salicylate toxicity (renal excretion possibly decreased, additive effects; incr. Upset stomach reliever and antidiarrheal. Adults—One dose (two 262.4 milligrams [mg] of bismuth subsalicylate, one 250 mg of metronidazole, and one 500 mg of tetracycline) 4 times a day, taken with meals and at bedtime, for 14 days. Bismuth subsalicylate should not be used in animals with known hypersensitivity or allergy to the drug. Common side effects include: constipation; or; dark colored stools. Bismuth subsalicylate is in a class of medications called antidiarrheal agents. Bismuth subsalicylate may cause side effects. Bismuth subsalicylate has anti-inflammatory, mild-antibiotic, antacid, and protective qualities. Found inside – Page 100Recommended adult doses are as follows : Agent Norfloxacin Ciprofloxacin Cotrimoxazole Bismuth subsalicylate Dosage 400 mg daily 500 mg daily 160/800 mg daily Two tablets with meals and at bedtime . The use of quinolones is difficult to ... It is used to treat the following conditions: For the symptomatic treatment of diarrhea. This medicine is used for heartburn and acid reflux, indigestion, diarrhoea and feeling sick (nausea). Dysentery—This condition may get worse; a different kind of treatment may be needed, Gout—The salicylate in this medicine may worsen the gout and make the medicines taken for gout less effective, Hemophilia or other bleeding problems—The salicylate in this medicine may increase the chance of bleeding, Kidney disease—There is a greater chance of side effects because the body may be unable to get rid of the bismuth subsalicylate, Stomach ulcer—Use of this medicine may make the ulcer worse. The medicine can be offered with a gap of 7-10 hours. If your doctor has told you to take bismuth subsalicylate regularly, take the missed dose as soon as you remember it. adults and children 12 years and over. Bismuth subsalicylate was well tolerated; the most common side effects were blackening of tongues and stools. Found inside – Page 378The short half - life of bismuth results in the need for 3 to 4 times daily dosing of the product , although the ... It has been recommended that tetracycline be administered along with bismuth subsalicylate ( BSS ) to facilitate ... The salicylate in bismuth subsalicylate is almost completely bioavailable 2; 15 mL of Pepto-Bismol liquid contains 130mg of salicylate. If any contain aspirin or other salicylates, be especially careful. Drink plenty of liquids while you are taking bismuth subsalicylate. Dosage in children with Helicobacter Pylori Infection is not well established, the following doses have been used in conjunction with ampicillin and metronidazole. Some side effects can be serious. Do not take more of this medication than recommended for your age. Don't take more than 8 doses in 24 hours. terminal half-life of salicylic acid upon a single oral dose of 525 mg bismuth subsalicylate is between 2 to 5 hours. Dosage. Found insideDESCRIPTION: Helidac Therapy consists of 1 12 bismuth subsalicylate 262.4 mg chewable tablets, 56 metronidazole 250-mg ... Bismuth: Less than 1% of bismuth from oral doses of bismuth subsalicylate is absorbed from the gastrointestinal ... Black stool and black tongue is common with use of Bismuth Subsalicylate. Any vomiting or diarrhea that persists for more than 24 hours needs your veterinarian’s attention. Common side effects include: constipation; or. Bismuth subsalicylate (Bismol) has got antisecretory, anti-inflammatory, and anti-diarrheal properties. Bismuth subsalicylate is an over-the-counter medication used for treatment of diarrhea, gas, upset stomach, indigestion, heartburn, nausea and as a prophylaxis for traveler's diarrhea. Clipboard, Search History, and several other advanced features are temporarily unavailable. Bismuth subsalicylate is a salicylate. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse. Top of the page bismuth subsalicylate Pronunciation: BIZ muth sub sa LISS i late Brand: Bismarex, Bismatrol, Bismatrol Maximum Strength, Kaopectate, Kola-Pectin DS, Peptic Relief, Pepto-Bismol, Percy Medicine, Pink Bismuth, Soothe Caplets Peptic Reliefslide 1 of 3, Peptic Relief, 262 mg, round, pink, imprinted with GDC 122 slide 1 of 3 Pink Bismuthslide 2 of 3, Pink This is only temporary and will go away when you Stop taking bismuth subsalicylate. It is a highly insoluble salt of trivalent bismuth and salicylic acid. Pediatric suspensions of bismuth subsalicylate is available containing 87 mg per 5 ml (one teaspoon). Call your doctor if you have any unusual problems while taking bismuth subsalicylate. For the two-day study period, the daily dosage was limited to 8 mg (40 ml) for loperamide-treated subjects and to 4.9 g for bismuth subsalicylate-treated subjects. For kids ages 2-11, turn to Pepto Kids, specially formulated for your little ones. Stomach: Bismuth subsalicylate is hydrolyzed in stomach to form slightly soluble bismuth oxychloride (BiOCl) and salicylic acid Small intestine: Unchanged bismuth subsalicylate passes into duodenum and reacts with other anions (eg, bicarbonate and phosphate) to form bismuth subcarbonate and bismuth phosphate salts Helidac is given together with a stomach acid reducer such as famotidine (Pepcid). Two tablespoons of Pepto-Bismol contain almost as much salicylate as one. Take 1 dose of Pepto Bismol every 30 min to an hour until you feel better. For example, bismuth subsalicylate is used for the relief of diarrhoea and upset stomach due to overindulgence in food and drink. Bismuth subsalicylate chewable tablets: Each pink round tablet contains 262.4 mg bismuth subsalicylate (102 mg salicylate) for oral administration. Active ingredient (in each tablet) Bismuth subsalicylate 262 mg. Upset stomach reliever and antidiarrheal. R01 AI 23049-01/AI/NIAID NIH HHS/United States. ; Patients should be instructed to take the medicines at mealtimes and at bedtime. Found inside – Page 98Prevention of travelers ' diarrhea by the tablet formulation of bismuth subsalicylate . JAMA 1987 ; 257 : 1347–1350 . The dosage of two tablets of bismuth subsalicylate four times daily ( 2.1 g / day ) appears to be a safe and effective ... Bismuth Subsalicylate should not be used if symptoms are severe or persist for more than 2 days. Tip: Refrigeration may increase the palatability of this drug, especially to cats and kittens. The typical dose administered to dogs is 0.5 to 1.5 ml per pound per day (1 to 3 ml/kg/day). Do not take 2 doses at the same time or extra doses. Among these completing the trial, diarrhea (four or more unformed stools in 24 hours or three in eight hours, plus one other symptom) occurred in seven (14%) of 51 receiving the high-dose regimen compared with 15 (24%) of 63 receiving the low-dose regimen and 23 (40%) of 58 in the placebo group. 2019 Jun 10;152(4):241-250. doi: 10.1177/1715163519853308. Within 48 hours of arrival in Mexico, 182 US students participated in a study to compare the efficacy of two dosages of bismuth subsalicylate (262 mg per tablet) as a prophylactic agent against diarrhea. Rev Infect Dis. This is not a complete list of side effects and others may occur. If you experience this symptom, stop taking this medication and call your doctor immediately: In some patients bismuth subsalicylate may cause dark tongue and/or grayish black stools. Tetracycline, Bismuth Subsalicylate, and Metronidazole This information from Lexicomp explains what you need to know about this medication, including what it's used for, how to take it, its side effects, and when to call your healthcare provider. Unable to load your collection due to an error, Unable to load your delegates due to an error. It should be used with great. Use until diarrhea stops but not longer than 2 days. Cats are very sensitive to aspirin so it should be avoided. For effectiveness, the dosing should be separated by at least two hours. General Description. Alternatively, 1048 mg to 1050 mg may be given orally every hour not to exceed 4 doses in any 24 hour period.